Does Medicare Cover a Hearing Test? Part B Rules and 2026 Amounts

Which hearing exams can Part B cover?

Part B pays toward a hearing exam when its purpose is diagnostic. Medicare.gov describes the covered service as diagnostic hearing and balance (fall risk) exams that your doctor or other health care provider orders to find out if you need medical treatment. The same page draws the line at devices: Original Medicare doesn't cover hearing aids or exams for fitting hearing aids.

So the purpose of the visit decides which rule applies:

• Ordered to find out if you need medical treatment: a diagnostic exam under Part B.
• To select or fit a hearing aid: outside Original Medicare coverage.

For a covered exam, your share is 20% of the Medicare-approved amount once the Part B deductible is met; Medicare.gov adds that other costs may apply. In a hospital outpatient setting you also pay the hospital a copayment, covered in the last section. The rules for the devices themselves are on does Medicare cover hearing aids.

When can an audiologist see you without an order?

Medicare.gov says you can visit an audiologist once every 12 months without an order from your health care provider, but only for non-acute hearing conditions and for diagnostic services related to hearing loss treated with surgically implanted hearing devices. The regulation behind it, 42 CFR 410.32, sets the allowance per patient per 12-month period without an order from the physician or nonphysician practitioner treating the patient, for certain diagnostic audiology tests that an audiologist personally furnishes.

Three conditions come with that allowance, all in the cited texts:

1. Non-acute conditions. The regulation says such diagnostic audiology tests can be for non-acute hearing conditions.
2. One period of 12 months. The allowance is counted per patient per 12-month period.
3. A billing modifier. Audiology services furnished without an order are billed using a modifier CMS designates for this purpose, and CMS names it the AB modifier.

Outside those limits, the route that Medicare.gov describes for covered exams is the one with an order from your doctor or other health care provider. The allowance does not make a visit free either: the Part B cost share described above still applies to a covered diagnostic test.

What does the CMS AB modifier rule exclude?

The no-order route carries its own exclusions. Under 42 CFR 410.32, those tests may not include audiology services that are related to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids that are outlined at § 411.15(d). A visit about a hearing aid therefore cannot use this route, and neither can a disequilibrium service.

CMS's Audiology Services page tells billers to use the AB modifier for these tests. To find out which audiology tests may be billed with it, the page points to its list of audiology services HCPCS codes. That list is the reference for AB membership, and it is a separate CMS document from the fee schedule table on this page:

• A code that appears in the table below has a national fee schedule amount.
• That amount does not place the code on the AB list, and the table does not mark which codes are on it.

To check a code, open the CMS Audiology Services page listed in this page's sources and follow its link to the code list. The modifier answers a billing question only: it says the test was furnished without an order, not that Medicare will pay for any particular visit.

Which national PFS reference amounts are available?

The table lists audiology codes from the CMS 2026 Physician Fee Schedule file, each on its unmodified row, and every row shown carries CMS status A. The amounts are national Medicare-approved amounts in two settings, non-facility and facility. They are the amount Medicare's payment is based on, and Medicare.gov's 20% share after the deductible is a share of this kind of amount. They are not an office's cash price and not a complete hospital bill.

Some rows as they appear in the table:

• 92557: $35.74 non-facility, $25.72 facility.
• 92567: $16.03 non-facility, $8.68 facility.
• 92620: $88.51 non-facility, $64.13 facility.
• 92552: $40.42 non-facility; facility amount not published for this row.
• 92584: $105.21 non-facility; facility amount not published for this row.
• 92652: $107.88 non-facility; facility amount not published for this row.

Some codes carry a facility amount. For the others the facility cell reads Not published for this row, which means the CMS file gives no amount there; it does not mean a zero amount. Rows are not meant to be added together into a visit total, since the table does not say which codes a given visit uses.

We show the codes without their CPT descriptions, because reuse permission for those descriptions has not been documented. The code number on a claim or bill is what to match against the table.

Which costs can an outpatient hospital add?

The setting changes the bill. Medicare.gov says that in a hospital outpatient setting you also pay the hospital a copayment, in addition to your Part B share. That hospital charge is not part of the fee schedule table: the professional amounts above are not a complete hospital outpatient bill, and this page does not estimate the hospital copayment.

What the page lets you read, then, comes in three separate pieces:

• the Part B rule for a covered exam and your 20% share after the deductible;
• the hospital outpatient copayment, named by Medicare.gov but not priced here;
• the national fee schedule amount per code, as a reference point.

Routine hearing exams offered by Medicare Advantage plans and free test routes are covered on free hearing test, and Medicare Advantage hearing benefits on Medicare Advantage hearing aid coverage. Fee schedule amounts by code are also discussed on hearing test cost, and testing for veterans on VA hearing test.